# CHINEA DENTAL LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1386987253
- **Authorized official:** SUSANA CHINEA (CEO)
- **Authorized official phone:** (575) 268-1679

## Contact information

- **Practice address:** 2101 S 1ST ST, TUCUMCARI, NM 88401-3807
- **Practice address phone:** (575) 268-1679
- **Practice address fax:** (505) 990-7514
- **Mailing address:** 2101 S 1ST ST, TUCUMCARI, NM 88401-3807
- **Mailing address phone:** (575) 268-1679
- **Mailing address fax:** (505) 990-7514

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | DD3249 | NM | Yes |

## Other

- **Enumeration date:** 03/29/2013
- **Last updated:** 03/29/2013